open access

Vol 49, No 4 (2017)
Original and clinical articles
Published online: 2017-09-25
Submitted: 2017-08-03
Accepted: 2017-09-03
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ET-View compared to direct laryngoscopy in patients with immobilized cervical spine by unexperienced physicians: A randomized crossover manikin trial

Katarzyna Karczewska, Lukasz Szarpak, Jacek Smereka, Marek Dabrowski, Jerzy Robert Ladny, Wojciech Wieczorek, Oliver Robak, Michael Frass, Sanchit Ahuja, Kurt Ruetzler
DOI: 10.5603/AIT.a2017.0047
·
Pubmed: 28953308
·
Anaesthesiol Intensive Ther 2017;49(4):274-282.

open access

Vol 49, No 4 (2017)
Original and clinical articles
Published online: 2017-09-25
Submitted: 2017-08-03
Accepted: 2017-09-03

Abstract

Background. Immobilization of the cervical spine is indicated in all patients with the potential risk of any cervical spine injury. Airway management in these patients is challenging and direct laryngoscopy is the standard of care. Videolaryngoscopes like the ET-View were introduced into clinical practice to provide better airway visualization and ease intubation. The ET-View is essentially a conventional endotracheal tube, but is equipped with a miniature camera on the tip. The ET-View has not been investigated in patients with immobilized cervical spine so far. The aim was to evaluate the performance of the VivaSight SL compared with Macintosh when performed in patients with immobilized cervical spine by unexperienced physicians.

Methods. This was prospective, randomized, cross-over manikin trial. 50 novice physicians were randomly assigned to intubate a manikin in three airway scenarios including a normal airway and two cervical immobilization techniques. Overall and first intubation attempt success rate, time to intubation, dental compression and airway visualization according to the Cormack&Lehane graduation were assessed.

Results. All physicians were able to intubate the manikin in all scenarios using the ETView, whereas direct laryngoscopy failed in 16 % with immobilized cervical spine using the patriot cervical extraction collar. First intubation attempt success rate was higher and airway visualization was better in all three scenarios using the ET-View compared to direct laryngoscopy.

Conclusion. The ET-View offered much better 62 airway visualization and provided higher overall and first intubation attempt success rates. Therefore, the ET-View is a valuable alternative in patients with difficult intubation due to immobilized cervical spine. Further clinical trials are indicated to confirm these findings.

Trial Registration: clinicaltrials.gov Identifier: NCT02733536.

Abstract

Background. Immobilization of the cervical spine is indicated in all patients with the potential risk of any cervical spine injury. Airway management in these patients is challenging and direct laryngoscopy is the standard of care. Videolaryngoscopes like the ET-View were introduced into clinical practice to provide better airway visualization and ease intubation. The ET-View is essentially a conventional endotracheal tube, but is equipped with a miniature camera on the tip. The ET-View has not been investigated in patients with immobilized cervical spine so far. The aim was to evaluate the performance of the VivaSight SL compared with Macintosh when performed in patients with immobilized cervical spine by unexperienced physicians.

Methods. This was prospective, randomized, cross-over manikin trial. 50 novice physicians were randomly assigned to intubate a manikin in three airway scenarios including a normal airway and two cervical immobilization techniques. Overall and first intubation attempt success rate, time to intubation, dental compression and airway visualization according to the Cormack&Lehane graduation were assessed.

Results. All physicians were able to intubate the manikin in all scenarios using the ETView, whereas direct laryngoscopy failed in 16 % with immobilized cervical spine using the patriot cervical extraction collar. First intubation attempt success rate was higher and airway visualization was better in all three scenarios using the ET-View compared to direct laryngoscopy.

Conclusion. The ET-View offered much better 62 airway visualization and provided higher overall and first intubation attempt success rates. Therefore, the ET-View is a valuable alternative in patients with difficult intubation due to immobilized cervical spine. Further clinical trials are indicated to confirm these findings.

Trial Registration: clinicaltrials.gov Identifier: NCT02733536.

Get Citation

Keywords

Endotracheal intubation; trauma; immobilization; physician; simulation.

About this article
Title

ET-View compared to direct laryngoscopy in patients with immobilized cervical spine by unexperienced physicians: A randomized crossover manikin trial

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 4 (2017)

Pages

274-282

Published online

2017-09-25

DOI

10.5603/AIT.a2017.0047

Pubmed

28953308

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(4):274-282.

Keywords

Endotracheal intubation
trauma
immobilization
physician
simulation.

Authors

Katarzyna Karczewska
Lukasz Szarpak
Jacek Smereka
Marek Dabrowski
Jerzy Robert Ladny
Wojciech Wieczorek
Oliver Robak
Michael Frass
Sanchit Ahuja
Kurt Ruetzler

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